Prediction of destination at discharge from a comprehensive rehabilitation hospital using the home care score.
Akiyoshi Matsugi, Keisuke Tani, Nami Yoshioka and 7 others
PMID 27821925WHAT IT FOUND
A home care score of 11 or more predicted returning home in Japanese rehabilitation patients.
For patients with a FIM score of 54 or less, the home care score was still useful. Both scores were higher at discharge than at admission.
Key findings
01A home care score cutoff of 11 predicted return to home at both admission and discharge.
02For patients with a FIM score of 54 or less, a home care score cutoff of 8 predicted return to home, with sensitivity 0.83, specificity 0.6, and positive predictive value 0.7.
03Home care score medians rose significantly from 11.5 at admission to 14 at discharge, and FIM medians rose significantly from 72 to 101.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
All patients were in Japanese comprehensive rehabilitation hospitals, and the home care score was developed by Japan's Ministry of Health and Welfare, so the cutoffs are tied to that care system. The patients' own physical or occupational therapists scored the measures, and the paper does not say those therapists were unaware of discharge plans. The study did not randomise patients or compare specific therapies, so it cannot separate the contribution of physical, occupational, or speech therapy. Patients who stopped rehabilitation because of cerebrovascular disease or osteoarticular disease recurrence were excluded. The study included only patients who had been independent in daily living before disease onset.
Declared interests
The supplied text does not report funding or conflicts of interest.
The easy way to misread this
Do not conclude that any one therapy caused the score increase or discharge home. Patients received comprehensive physical, occupational, and speech therapy, and the study did not isolate those components. Do not treat the home care score cutoff of 11 as a general decision rule; it was derived in Japanese comprehensive rehabilitation hospitals.